Enhancing diabetic foot osteomyelitis diagnosis with metagenomics next‐generation sequencing, proof of concept
Authors' conclusion
Integrating mNGS into routine clinical microbiology may serve as a complementary method to conventional diagnostics, particularly for distinguishing infection from colonization and predicting clinical outcomes.
Study context
- Population
- Diabetic persons with suspected diabetic foot osteomyelitis (DFOM); 10 bone biopsies from 9 persons10 bone biopsies
- Participants
- 9 persons
- Comparison
- Metagenomics next-generation sequencing (mNGS) vs routine microbiological culture of bone biopsies
- Outcome
- Bacterial species identified in bone biopsies
Methodological detailsproof of concept
- Proof of concept
Performance
As reported in the abstract
Routine culture
11 bacterial species across seven biopsies
mNGS
84 species, including all those found by culture
Further findings
Microbial diversity and clinical outcome
- High microbial diversity (Shannon index) associated with severe osteomyelitis
- 1.10
- DFOM cases leading to amputation
- three of seven
- One culture-negative biopsy showed high bacterial diversity by mNGS and progressed to severe infection
- within 7 days
Resistance genes
- mNGS also identified resistance genes
Original publication
Enhancing diabetic foot osteomyelitis diagnosis with metagenomics next‐generation sequencing, proof of concept. Diabet Med. Published 15 February 2026. doi:10.
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